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Organization
EASTERN KANSAS HEALTH CARE SYSTEM
Active
Organization
EASTERN KANSAS HEALTH CARE SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIROUS NOURBAKHSH PA-C (PHYSICIAN ASSISTANT)
(785) 350-3111
Entity
Organization
Contact information
Practice address
112 TUMBLEWEED DR, LAWRENCE, KS 66049-4151
(785) 841-4707
Mailing address
112 TUMBLEWEED DR, LAWRENCE, KS 66049-4151
(785) 841-4707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00217
KS
Other
Enumeration date
07/22/2006
Last updated
08/22/2020
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